Casandra L Gibson

Individual provider Active NPI Behavior Analyst · Newberry, MI

NPI 1396668992 · NPPES record last updated Jul 31, 2026

Key facts

NPI
1396668992
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
106S00000X (MI)
Practice address
14126 County Road 428
Newberry, MI 49868-7762
Phone
(906) 293-3284
NPI assigned
Jul 31, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 106S00000X MI Yes

Addresses

Primary practice location

14126 County Road 428
Newberry, MI 49868-7762

Mailing address

PO Box 114
Newberry, MI 49868-0114

Other providers in Newberry, MI

All providers in Newberry, MI · Behavior Analyst in Michigan

Sources for this page

Verify at the official NPI Registry.